Cataract and the use of statins: a case-control study

Smeeth, Liam; Hubbard, Richard; Fletcher, A. E.

doi:10.1093/qjmed/hcg064

Cited by 41 publications

(38 citation statements)

References 21 publications

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“…For example, one study of statin use reported a decrease in risk of nuclear cataracts with a tendency for an increased risk of cortical cataracts,10 while another early study of pravastatin found no association but only studied 14 patients 33. Smeeth et al reported an increased risk of cataract of similar magnitude to that obtained in our study which did not vary by type, dose or duration of use 34. This increase was largely explained by an increase in consultation rates, which suggests that the increased risk may be more an ascertainment bias than a true biological effect.…”

Section: Discussionsupporting

confidence: 86%

Individualising the risks of statins in men and women in England and Wales: population-based cohort study

Hippisley‐Cox

Coupland²

2010

Heart

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Objective To derive and validate risk algorithms so that the risks of four clinical outcomes associated with statin use can be estimated for individual patients. Design Prospective open cohort study using routinely collected data from 368 QResearch general practices in England and Wales to develop the scores. The scores were validated using two separate sets of practicesd188 separate QResearch practices and 364 practices contributing to the THIN database. Subjects In the QResearch derivation cohort 225 922 new users of statins and 1 778 770 non-users of statins were studied. In the QResearch validation cohort 118 372 statin users and 877 812 non-users of statins were studied. In the THIN validation cohort, we studied 282 056 statin users and 1 923 840 non-users of statins were studied. Methods Cox proportional hazards models in the derivation cohort to derive risk equations. Measures of calibration and discrimination in both validation cohorts.Outcomes 5-Year risk of moderate/serious myopathic events; moderate/serious liver dysfunction; acute renal failure and cataract. Results The performance of three of the risk prediction algorithms in the THIN cohort was very good. For example, in women, the algorithm for moderate/serious myopathy explained 42.15% of the variation. The corresponding D statistics was 1.75. The acute renal failure algorithm explained 59.62% of the variation (D statistic¼2.49). The cataract algorithm explained 59.14% of the variation (D statistic¼2.46). The algorithms to predict moderate/severe liver dysfunction only explained 15.55% of the variation (D statistics¼0.89). The performance of each algorithm was similar for both sexes when tested on the QResearch validation cohort. Conclusions The algorithms to predict acute renal failure, moderate/serious myopathy and cataract could be used to identify patients at increased risk of these adverse effects enabling patients to be monitored more closely. Further research is needed to develop a better algorithm to predict liver dysfunction. BACKGROUND

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Section: Discussionsupporting

confidence: 86%

Individualising the risks of statins in men and women in England and Wales: population-based cohort study

Hippisley‐Cox

Coupland²

2010

Heart

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“…We found no evidence to support a beneficial effect. Previous reports of effects on cataract [10,32,33] and age-related macular degeneration [11,34] have been inconsistent. Our study suggests that statins have minimal or no effect on these eye diseases.…”

Section: Comparison Of Results With Previous Studiesmentioning

confidence: 97%

“…Many disease processes have been suggested to be affected by statin use, including protection from infectious processes [5]; effects on cancer [6,7]; protection against dementia [8] and fractures [9]; effects on the eye [10,11] and a range of neurological [12,13] and immune-mediated diseases [14]. However, outside clinical trials, exposure to statins is not randomized, but is determined by a wide range of health-related factors.…”

Section: Introductionmentioning

confidence: 99%

Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials

Smeeth

Douglas

Hall

et al. 2008

Brit J Clinical Pharma

215

201

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• The effect of statins on cardiovascular outcomes is well established.• Effects on numerous other health outcomes have been claimed, but results have been inconsistent.• Previous observational studies may have been affected by selection bias and confounding. WHAT THIS STUDY ADDS• This study was larger and more statistically powerful than the combined total of data from all randomized trials of statins undertaken to date.• The validity of the study is supported by findings for vascular outcomes being comparable to those observed in large randomized controlled trials.• There was little evidence to support effects of statins beyond their established effects on cardiovascular disease. AIMSTo assess the effect of statins on a range of health outcomes. METHODSWe undertook a population-based cohort study to assess the effect of statins on a range of health outcomes using a propensity score-based method to control for differences between people prescribed and not prescribed statins. We validated our design by comparing our results for vascular outcomes with the effects established in large randomized trials. The study was based on the United Kingdom Health Improvement Network database that includes the computerized medical records of over four and a half million patients. RESULTSPeople who initiated treatment with a statin (n = 129 288) were compared with a matched sample of 600 241 people who did not initiate treatment, with a median follow-up period of 4.4 years. Statin use was not associated with an effect on a wide range of outcomes, including infections, fractures, venous thromboembolism, gastrointestinal haemorrhage, or on specific eye, neurological or autoimmune diseases. A protective effect against dementia was observed (hazard ratio 0.80, 99% confidence interval 0.68, 0.95). There was no effect on the risk of cancer even after Ն8 years of follow-up. The effect sizes for statins on vascular end-points and mortality were comparable to those observed in large randomized trials, suggesting bias and confounding had been well controlled for. CONCLUSIONSWe found little evidence to support wide-ranging effects of statins on health outcomes beyond their established beneficial effect on vascular disease.

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“…However, the findings in these studies are inconsistent and controversial. While some of them did not report an association between statin use and cataract (9,10,11,12), some found a protective effect of statins on cataract (5,6,7). Recently, few studies demonstrated an increased risk of cataract associated with statins (2,4,5,13,14).…”

Section: Discussionmentioning

confidence: 99%

The effect of statin use on lens density as assessed by pentacam hr® lens densitometry in adults

Çakir¹,

Tokatlı²,

Kar³

et al. 2016

Med Sci and Discov

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Cataract and the use of statins: a case-control study

Abstract: In the short- and medium-term, statins do not seem to be associated with an increased risk of cataract. The need to assess the effects of long-term statin exposure on the eye remains.

Cited by 41 publications

References 21 publications

Individualising the risks of statins in men and women in England and Wales: population-based cohort study

Individualising the risks of statins in men and women in England and Wales: population-based cohort study

Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials

The effect of statin use on lens density as assessed by pentacam hr® lens densitometry in adults

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